Accuracy and safety of the endoscopic repair of the distal biceps : a cadaveric study

Abstract

Clinical results of endoscopic distal biceps tendon repair have been shown to be comparable to open techniques in small series. This study evaluates safety and accuracy of the endoscopic technique. Sixteen fresh-frozen paired cadaveric upper extremities were used. The distal biceps tendons were cut and then repaired with the classic single incision bone button technique. Eight were done through an open technique, and eight were repaired endoscopically. Safety and accuracy were assessed by comparing the distance of the repair to neurovascular structures as well as the distance of the bone tunnel to the native biceps insertion. Paired t-tests were used to compare measurements. Significance level was set at p=0.05. There were no significant differences between the open and endoscopic groups, for any of the anatomic measurements. The ulnar artery was the closest neurovascular structure to the tunnel, with an average of 1 mm. The radial and recurrent radial arteries were located at 3 and 19 mm respectively. The median nerve was an average 10 mm from the tunnel, and both the SBRN and PIN at 12 mm. The distance between the PIN and the endobutton at the posterior side of the radius was an average 6 mm. There were no significant differences in variance between both groups related to the placement of the tunnel relative to the native biceps insertion. The single incision endoscopic-assisted technique of distal biceps repair can be performed consistently and with no added risk to neurovascular structures when compared to the classic open technique.